Life in a Bind – BPD and me

Borderline Personality Disorder, Generalized Anxiety Disorder, and my therapy journey. Listed in Top Ten Resources for BPD in 2016 by goodtherapy.org. I write for welldoing.org under the name Clara Bridges.

Self-harm – in under two minutes

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*TRIGGER WARNING*

In a way, I was rather relieved when my one of my ex-therapists (let’s call her Nina), did and said something so objectionable, that all of the other objectionable things that she said and did paled into insignificance. I had been feeling as if my previous annoyance might have been unjustifiable, and I was worried that I had not been ‘giving her a fair go’ due to the fact that she looked as though she was still in high school.

Never mind the fact that she twirled her hair during sessions, while I was pouring out my emotions and pain. Perhaps I was being over-sensitive when I found that mildly irritating and somewhat offensive. And maybe her bizarre habit of pretending to draw diagrams and write sentences with her hand on the wall next to her chair, was actually helpful to some of her other clients. As if somehow it would help me to better understand what she was driving at – it didn’t.

But it was her attitude and approach to self-harm that, quite literally, made me see red. It made me want to quit therapy, and it almost led me to write a letter of complaint to her employers, and if you knew how very much I hate complaining about anything, you would understand just how angry I must have been. Just the other day I paid twice the advertised price for a piece of cake in the canteen because I didn’t want to make a fuss – you get the picture.

It wasn’t even the fact that she called self-harm ‘unhelpful’, though that in itself betrayed, at worst, a worrying lack of insight, and at best, a worrying lack of care in her use of words. As someone who has been self-harming for the last couple of years, I would agree that it is not a particularly healthy coping mechanism, and ultimately it is not ‘helpful’ to recovery. However, it  is a coping mechanism, and as such, it is helpful to the individual who uses it. Please don’t misunderstand me – I’m not in any way advocating self-harm, or trying to undermine the immense and courageous efforts of those who struggle daily to stay free of it. That’s why there is a *trigger warning* at the start of this post – I would hate for anything I say to act as a catalyst for anyone’s self harm.

I’m just making the point that if it was not helpful in one way or another to the individual concerned, they probably wouldn’t do it. I’m not defining or restricting the ways in which it can be helpful. In fact, the longer my self-harming goes on, the more I realise that it can mean very different things to different people, and different things to the same person, over time. Self-harm evolves, it changes, it’s never quite the same tomorrow as it was today. And the reasons, motivations, and meanings behind it are myriad.

The incident that took my breath away (though not in a positive sense), involved both a visual image and a statement that she used in response to the fact that I had said that sometimes, although I was desperate to self-harm, I just didn’t have the time to do it. I think it was the image, more than the words, that I found so utterly abhorrent. It was as if she had suddenly entered a very private part of my psyche, and had just defiled it by trampling all over it.

“Surely it only takes a couple of minutes – you just go into the bathroom and make a quick cut?”. Her right hand made the action of drawing a razor blade across her left wrist. The room was suddenly silent – the air laden with assumptions.

I wouldn’t expect most people who did not have personal experience of self-harm, to have a great deal of knowledge or understanding about it, although it saddens me that there is still the widely-held misconception that all those who self-harm are wanting to end their lives, whereas in fact they might be fighting in the only way that they know how, to stay alive. However, I think it’s only right to hold professionals to a different set of standards: to expect a more in-depth level of knowledge and understanding, and a sensitive and appropriate response to a client’s discussion of self-harm. For some, even raising the topic openly in therapy may feel risky and may be a tremendously painful and uncomfortable experience.

I had never told Nina what form my self-harm took – cutting may be one of the most common, but there are many other methods. I had also never told her where I self-harmed. In my case, although I do cut, it’s most frequently on my hips (and at that time, was almost exclusively on my hips). It felt as though her words and actions were a gross generalisation of an incredibly complex phenomenon. But more than that, I found them insulting in the way that they seemed to display a lack of care, interest and sensitivity in my own particular circumstances – not only in the form that my self-harm took, but in the reasons and the motivations behind it, and in what it was trying to express. It felt like a complete disregard of me as a person – although I didn’t have the language to describe it as such at the time, it felt incredibly invalidating.

Quite uncharacteristically (I hate confrontation even more than I hate complaining), I plucked up the courage to tell her, at the end of the session, that for me, self-harming takes a hell of a lot longer than two minutes. Either fortunately or unfortunately, depending on how you look at it, with small children and a husband almost constantly around, I can rarely self-harm completely on impulse. Plus, as any parent will know, a mother’s trips to the bathroom are rarely unaccompanied! In addition, I have to hide my ‘tools’ very well, not only for the sake of keeping my self-harm secret, but so that they are not accessible to my children. That’s aside from the fact that I find I need to make several cuts in one sitting, and that clearing up ‘the evidence’ after the event, takes time.

All of which adds up to substantially more than two minutes.

 

[There are a large number of helpful and informative websites by charities and national or governmental bodies of various kinds, for those dealing with self-harm, and for those supporting them. There are some in particular, that I hope to reference and write about in future posts. There are also a very large number of excellent blog posts out there on self-harming, including these, on ten common self-harming methods, and on two less frequently talked about methods, trichotillomania, and dermatillomania. Finally, I was very much struck by this post, entitled ‘Self-harm is normal’ – a real plea for openness and acceptance of something that is ‘normal’ not in the sense that it should be ‘normalized’ within society as a whole, but by virtue of the fact that it is part of the language and landscape of so many different types of mental health difficulties.] 

 

 

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12 thoughts on “Self-harm – in under two minutes

  1. Crappy therapist. Yep, you should definitely complain about that one.

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    • Thank you so much for your comment – crappy indeed. I do want to write, I have always felt guilty when I have not acted in other situations like this, particularly when it could have prevented someone else going through the same thing……I just feel so overwhelmed by other things at the moment, that I think I will need to put it on hold for a short while. I’m wondering whether I posted about it because it’s simply too difficult at the moment to write about and process the things I’m in the thick of. Somehow reflecting on this incident, at a safer distance, felt easier…..

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      • I totally know how it’s easier in hindsight because when you are in the thick of things you are just that – in the thick of things. It’s definitely easier looking back.

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      • Doreen – yes, it’s much easier looking back. Even the space of a day can make a difference (to some things….not to others!). I would like to be able to write ‘while in the thick of things’, by way of ‘processing stuff’, but somehow there’s too much feeling and too much thinking going on, and all of it all jumbled together, to be able to make written sense of it! Thank you for commenting! x

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  2. Wow! In addition to what you’ve rightly stated, her action could have been immensely triggering for those who either do or want to engage in that particular form of self-harm. It reads like an incredulous 13-year-old schoolboy with a morbid, inappropriate curiosity with no heed for the impact he has.

    I’d suggest you write the letter of complaint without pressuring yourself to send it? A way of getting clearer with yourself as to what you will and won’t put up with?

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    • Thank you! You’re right, it could have been immensely triggering (I was so triggered by all sorts of things at the time, I’m not sure it made it much worse, but it could so easily have done, in a different situation….). I think actually her attitude, and feeling misunderstood, triggered more self-harm in itself. Writing it all down is a good idea – I need to try and deal with my dire home situation and try and organise some couples therapy as a priority, as well as try and somehow deal with what I now know is the finality of losing Jane, but at some point, I would like to think I have taken action on this, because it is so important, both to process, and possibly to try and prevent someone else being in this situation. I would also like to write to the organisation through which I saw Jane, and that may be even more pressing, given how I feel now. They had a ‘rule’ that meant therapists could not refer people to themselves in private practice, if they had seen them through the free service. However, the ‘exclusion period’ was a matter of months, and for someone with the degree of attachment that I formed, that is nowhere near long enough to allow a separation/grieving process to occur, and means that, as in my case, there is a risk of putting one’s life on hold, feeling in limbo, refusing to accept or grieve the loss, etc. I’m tempted to think that the period should either be longer, or that there should be flexibility to refer privately immediately, on a case-by-case basis, while still trying to ensure ethical frameworks are maintained and there is no question of the therapist taking advantage of the patient for financial gain. Another blogger once described the experience of going through enforced therapy changes (or changes due to ‘poor therapy’) as ‘medical trauma’, and I have some sympathy with that. If a doctor’s first mandate is to ‘do no harm’, it seems to me that a great deal of harm can be done albeit within the noble and right pursuit of trying to maintain ethical boundaries and practices, by enforcing a potentially needless separation between client and therapist in an environment where therapy is happening successfully, and a strong and productive attachment has formed……Thank you again for your comment, which I really appreciate. And I think your description of ‘Nina’ is exactly how it came across!

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  3. What an extraordinary thing to say! Surely also, that conversation was about thinking about ways you can self harm less, which she totally missed by effectively questioning why you don’t hurry up and do it more frequently?! I’m glad to hear she is not your therapist any more, frankly it’s faintly terrifying that with an attitude like that she is anyone’s.

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    • I agree, it is rather terrifying! The only consolation is that she is unlikely (at least in her current setting) to be anyone’s long-term therapist. I saw her for a ‘free’ course of CBT for around 12 sessions, so as far as I’m aware, she only does time-limited work. With more than enough time, however, to potentially do damage to some that she sees. What’s worrying as well, is that she was supposedly a ‘more qualified’ CBT counsellor than the first CBT person I saw through this service, who dealt immeasurably better with my self-harm. I was ‘stepped up’ from a low/medium level of support (6 sessions) to a ‘high’ level of support (according to the definitions and type of support offered by this service) which consisted of 12 sessions. This was all a couple of years ago, before I realised that CBT really wasn’t the right kind of therapy for me right now, and before I moved onto psychotherapy instead…..

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  4. W. T. F. – ! Ugh, someone like this wielding therapy (“therapy”) is like the village idiot wielding a semi-automatic. So much potential for damage that it’s basically dangerous NOT to call her out on it… glad you did! xxxxxxx

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  5. Pingback: Self-harm: a few thoughts | Life in a Bind - BPD and me

  6. I have read many posts of you but this one hit me hard. I felt so angry by reading your T’response about self harm that I had to read it many times.
    Half year ago I had a therapist and we used to have a talk about self harm and suicide,telling her for my previous attempts and how sh helped me to stay alive(after all cannot hide every scar of my body ) until that day. She knew I was suicidal so cutting was one way to die. Her response had made me feel outrageous when said “Your self harm has nothing to with death. If you wanted to suicide you had take a gun. But no,you are a attention seeker. ”
    Never realized how quickly screamed at her saying she wasn’t a professional and had no idea about these things bfd I slammed the door behind me. Never returned back there.

    Liked by 1 person

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